The most common forms of CAM include acupuncture, homeopathic remedies, herbal medicines and yoga. This increased use of CAM seems to be based on distrust of conventional and scientific-based medicine, bad experiences with physicians, and/or belief that CAM is safe, natural and without side effects.
AcupunctureAcupuncture is a part of traditional Chinese medicine and used for many chronic diseases, including allergic rhinitis and asthma. The process involves inserting needles into the skin at exact points on the body, which is supposed to restore the balance of "vital flows".
Most studies on acupuncture used to treat asthma are poorly designed, and are not up to typical scientific standards. Many of these studies fail to include a "control" (a placebo, or "fake" treatment) group, as well as lack of "blinding" (meaning the researchers don't know who is getting the real treatment and who is getting a placebo treatment, so they cannot be biased) as part of the study design.
A review of the available well-controlled studies on acupuncture fails to show little, if any, benefit on the treatment of asthma.
Studies on acupuncture in the treatment of allergic rhinitis are, for the most part, poorly designed, although a few show benefit over placebo. One study performed in children, using 3 months of acupuncture treatment and 3 months follow-up after treatment, did show benefit in those children who received the "real" acupuncture, although they still required the same amount of medication for their allergies as the placebo group.
Herbal MedicationsVarious herbal supplements have been used in the treatment of allergies and asthma, some showing benefit. Many medications used to treat various medical problems are derived from plants and herbs, including theophylline (long used to treat asthma).
Asthma. Studies on herbs in asthma have shown benefit when compared to placebo, although many studies are poorly designed. Helpful herbs in asthma include Chinese herb mixes, Tylophora indica (Indian ipecac), and to a lesser degree, Boswellia serrata, butterbur and saiboku-to (TJ96). On the other hand, Picrorrhiza kurroa has not been shown to be effective in the treatment of asthma.
Despite some promising results with use of the above herbs, a careful review of these studies shows no convincing evidence that herbs are helpful in the treatment of asthma.
Allergic rhinitis. Studies on herbs in allergic rhinitis have been the more promising, with at least two studies on the use of butterbur in the treatment of allergic rhinitis. One well-designed study showed that butterbur was equivalent to cetirizine (Zyrtec®), while another showed that butterbur was equivalent to fexofenadine (Allegra®). Another well-controlled study on perennial allergic rhinitis showed that biminne was effective for allergic rhinitis symptoms compared to placebo. Finally, a well-designed study showed that a Chinese herb mix was more effective on allergic rhinitis symptoms than placebo.
However, other studies using butterbur show no difference over placebo in treating symptoms in people with intermittent allergic rhinitis. Grapeseed extract was also not found to be helpful in the treatment of seasonal allergic rhinitis.
While herbal supplements do show promise in the treatment of asthma and allergic rhinitis, there are some clear drawbacks. Herbs are not without side effects (some extremely dangerous), and have known interactions with many prescription medications. Herbal supplements are not regulated by the Food and Drug Administration in the same manner as prescription medications, so purity is not guaranteed. Therefore, it makes little sense to take herbal supplements because they are safer than prescription medications.
HomeopathyHomeopathy is based on the idea that diseases can be cured by giving the substance that causes the disease back to a person in extremely small amounts. This is a similar to the principle used in immunotherapy, except in much smaller doses that have proven to be beneficial with using allergy shots.
Asthma. Three well-designed studies show little to no benefit of homeopathic remedies in the treatment of asthma.
Allergic rhinitis. Some studies show a benefit of homeopathy in the treatment of allergic rhinitis, with benefit over anti-histamines such as chlorpheniramine or equivalence to cromolyn nasal spray. However, numerous other studies show no benefit of homeopathy compared to placebo.
Despite some encouraging results in some small, selected studies, the overall evidence for homeopathy is weak, while evidence for conventional medications in the treatment of allergic rhinitis and asthma is very strong.